title: Multiple isolated sinus dural arteriovenous fistulas associated with antithrombin III deficiency--case report--.
abstract: A 55-year-old man presented with a rare case of multiple isolated sinus dural arteriovenous fistulas (AVFs) associated with antithrombin (AT) III deficiency manifesting as sudden onset of headache and gait disturbance. Increased arterial shunting flow had caused intraventricular hemorrhage after incomplete repeated transarterial embolization procedures for dural AVFs. Multiple isolated sinus dural AVFs were located in the anterior superior sagittal sinus (SSS) and transverse sinus, which were completely embolized by direct packing of the isolated sinuses via the SSS. The development of dural AVF is complicated and associated with a number of factors, such as congenital abnormality, head trauma, craniotomy, radiation, hematological abnormality, and sinus thrombosis. Hematological abnormality is a risk factor of sinus thrombosis. In the present case, the multiple isolated sinus dural AVFs might have resulted from the aggravation of multiple dural AVFs and the coagulative tendency due to AT III deficiency. Direct sinus packing should be considered if transvenous catheterization is difficult or fails.
authors.affiliation: Department of Neurosurgery, Aomori Prefectural Central Hospital, Aomori. satsushi2002@yahoo.co.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.forename: Noboru
authors.initials: N
authors.lastname: Takahashi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Furuno
authors.forename: Hironaga
authors.initials: H
authors.lastname: Kamiyama
authors.forename: Shinjitsu
authors.initials: S
authors.lastname: Nishimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Midorikawa
authors.forename: Michiharu
authors.initials: M
authors.lastname: Nishijima
mesh_terms: D020152:Antithrombin III Deficiency / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D015984:Causality; D020785:Central Nervous System Vascular Malformations / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D002552:Cerebral Ventricles / Q000473:pathology / Q000503:physiopathology; D003392:Cranial Sinuses / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000592:standards; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000592:standards